A high PSA (prostate-specific antigen) level can be the first sign of prostate cancer, but it can also be a sign of less serious conditions. Here are some factors that can cause high PSA levels besides cancer:

• Age: As men get older, their prostate gland naturally gets larger, which can increase PSA levels.

• Prostate size: An enlarged prostate, also known as benign prostatic hyperplasia (BPH), can increase PSA levels.

• Prostatitis: Inflammation of the prostate gland, known as prostatitis, can elevate PSA levels because inflammation in the prostate gland can make excess PSA leak into the bloodstream.

• Urinary tract infection: A urinary tract infection (UTI) can cause higher than normal PSA levels, although the reason for this is not clear.

• Physical activity: Vigorous exercise, such as cycling, can cause a temporary increase in PSA levels. It is recommended to avoid strenuous physical activity for about 48 hours before a PSA test for accurate readings.

• Digital rectal exam: A digital rectal exam (DRE) can also cause a temporary increase in PSA levels. For the most accurate results, it is recommended to have the PSA test done before the DRE.

• Recent prostate biopsy: A recent prostate biopsy will increase the PSA level.

• Medications: Some medications, such as 5-alpha reductase blockers used to treat BPH, can lower PSA levels.

It is important to note that a high PSA level does not necessarily mean that a person has prostate cancer. Other factors can cause PSA levels to fluctuate, and further testing is needed to determine the cause of the high PSA level.